Skip to main content

Trigeminal nerve block and surgery

  • Chapter
  • 146 Accesses

Part of the Topics in Anaesthesia and Critical Care book series (TIACC)

Abstract

The trigeminal nerve is one of the peripheral nerves often involved in painful conditions. It supplies the sensory fibers to the entire face and the anterior two-thirds of the head. It is the target of “tic douloureux”, a fascinating disorder, characterized by paroxysmal lancinating pain which is triggered by non-noxious tactile stimulation and which is probably the most tractable chronically painful condition known. Furthermore, along its intra- and extracranial course, the trigeminal nerve is commonly subject to trauma from head injury, tumor, sinus disease, facial trauma, dental procedures and other causes, presenting, like other peripheral nerves, a broad spectrum of associated syndromes of neuropathic pain, often included in the wastebasket diagnosis of “atypical facial pain”. Thus, since the early nineteenth century it has been the object of direct surgical attempts to injure this nerve with the aim of pain relief. Some decades later, it was suggested that a peripheral nerve might be destroyed by injecting a toxic substance into it and Bartholow used chloroform for this in 1876 [11: the dichotomy between open surgery and percutaneous techniques, still debated nowadays, was born. In this chapter techniques, indications and results of trigeminal nerve surgery and block will be described and discussed.

Keywords

  • Nerve Block
  • Trigeminal Nerve
  • Mental Foramen
  • Anaesthetic Solution
  • Lingual Nerve

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

This is a preview of subscription content, access via your institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • DOI: 10.1007/978-88-470-2240-9_15
  • Chapter length: 14 pages
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
eBook
USD   84.99
Price excludes VAT (USA)
  • ISBN: 978-88-470-2240-9
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
Softcover Book
USD   109.00
Price excludes VAT (USA)

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Mullan S, Brown JA (1996) Trigeminal neuralgia. Neurosurgical Q 6: 267–288

    CrossRef  Google Scholar 

  2. Cook WA (1995) The mandibular field and its control with local anaesthetic Mod Dent 22: 11–14

    Google Scholar 

  3. Carter RB, Keen EN (1971) The intramandibular course of the inferior alveolar nerve. J Anat 108: 433–441

    PubMed  CAS  Google Scholar 

  4. Gow-Gates GAE (1973) Mandibular conduction anasthesia: a new technique using extraoral landmarks. Oral Surg Oral Med Oral Pathol 36: 328–331

    CrossRef  Google Scholar 

  5. Dandy WE (1934) Concerning the cause of trigeminal neuralgia. Am J Surg 24: 447–455.

    CrossRef  Google Scholar 

  6. Gardner WJ, Miklos MV (1959) Response of trigeminal neuralgia to “decompression” of sensory root. Discussion of cause of trigeminal neuralgia. JAMA 170: 1773–1776

    Google Scholar 

  7. Jannetta PJ (1967) Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgia. J Neurosurg 26: 159–162

    PubMed  CrossRef  Google Scholar 

  8. Broggi G, Ferrol,; P, Franzmi A, Servello D, Dones I (1998) Microvascular decompression for trigeminal neuralgia: considerations on a series of 250 cases, including 10 patients with multiple sclerosis. J Neurol Neurosurg Psychiatry (In press)

    Google Scholar 

  9. Barker FG, Jannetta JJ, Bissonette DJ, Larkins MV, Jho HD (1996) The long-term outcome of microvascular decompression for trigeminal neuralgia. N Engl J Med 334: 1077–1083

    Google Scholar 

  10. Hartel F (1914) Trigeminusneuralgie and ganglion injection. Med Kim 10. 582–584

    Google Scholar 

  11. Gybels JM, Sweet WH (1989) Neurosurgical treatment of persistent pain Physiological and pathological mechanisms of human pain In: Gildenberg PL (ed) Pain and headache, Vol 11. Karger, Basel, pp 30–40

    Google Scholar 

  12. Sweet WH, Wespic JG (1974) Controlled thermocoagulation of trigeminal ganglion and rootlets for differential distrucnon of pain fibers. J Neurosurg 40:143–156

    Google Scholar 

  13. Broggi G, Siegfried J (1977) The effect of graded thermocoagulation on trigeminal evoked potentials in the cat. Acta Neurochir 24 (Suppl): 175–178

    CrossRef  Google Scholar 

  14. Broggi G, Franzini A, Lasio G, Giorgi C, Servello D (1990) Long-term results of percutaneous retrogassenan thermorhizotomy for “essential” tngeminal neuralgia: considerations in 1000 consecutive patients Neurosurgery 26: 783–787

    CAS  Google Scholar 

  15. Hakanson S (1981) Trigeminal neuralgia treated by the injection of glycerol into the trigeminal cistern. Neurosurgery 9: 638–646

    PubMed  CrossRef  CAS  Google Scholar 

  16. Mullan S, Lichtor T (1983) Percutaneous microcompression of the trigeminal ganglion for trigeminal neuralgia. J Neurosurg 59. 1007–1012

    PubMed  CrossRef  CAS  Google Scholar 

  17. Shelden CH, Pudewz RH, Freshwater DB (1955) Compression rather than decompression for trigeminal neuralgia. J Neurosurg 12: 123–126

    PubMed  CrossRef  CAS  Google Scholar 

  18. Preul MC, Long PB, Brown JA, Velasco ME, Weaver MT (1990) Autonomic and histopathological effects of percutaneous trigeminal ganglion compression in the rabbit. J Neurosurg 72: 933–940

    PubMed  CrossRef  CAS  Google Scholar 

  19. Lobato RD, Rivas JJ, Sarabia R, Lamas E (1990) Percutaneous microcompression of the gassenan ganglion for trigeminal neuralgia J Neurosurg 72: 546–553

    CAS  Google Scholar 

  20. Lichtor T, Mullan JF (1990) A 10-year follow-up review of percutaneous microcompression of the trigeminal ganglion. J Neurosurg 72.49–54

    Google Scholar 

  21. Steude U (1984) Radiofrequency electrical stimulation of the gassenan ganglion in patients with atypical trigeminal pain: methods of percutaneous temporary test-stimulation and permanent implantation of stimulation devices. Acta Neurochir 33: S481 - S486

    Google Scholar 

  22. Meyerson BA, Hakanson S (1986) Suppression of pain in trigeminal neuropathy by electrical stimulation of the Gassenan ganglion. Neurosurgery 18: 59–66

    PubMed  CrossRef  CAS  Google Scholar 

  23. Meyerson BA, Hakanson S (1980) Alleviation of atypical trigeminal pain by stimulation of the gassenan ganglion via an inplanted electrode. Acta Neurochir 30: S303 - S309

    CrossRef  Google Scholar 

  24. Schvarcz JR (1979) Stereotactic spinal trigeminal nucleotomy for dysesthetic facial pain. Adv Pain Res Ther 3: 331–336

    Google Scholar 

  25. Nashold BS, Lopes H, Choda Kiewitz J, Bronec P (1986) Trigeminal DREZ for craniofacial pain. In: Samn M (ed) Surgery in and around the brainstem. Springer-Verlag, Berlin Heidelberg New York, pp 53–58

    Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and Permissions

Copyright information

© 1999 Springer Verlag Italia, Milano

About this chapter

Cite this chapter

Broggi, G., Franzini, A., Ferroli, P. (1999). Trigeminal nerve block and surgery. In: Tiengo, M., Paladini, V.A., Rawal, N. (eds) Regional Anaesthesia Analgesia and Pain Management. Topics in Anaesthesia and Critical Care. Springer, Milano. https://doi.org/10.1007/978-88-470-2240-9_15

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-2240-9_15

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0044-5

  • Online ISBN: 978-88-470-2240-9

  • eBook Packages: Springer Book Archive